Sunday, 12 May 2013

Nurses at the centre of stroke care in Ghana

The Wessex-Stroke Partnership was established in 2009, supported with funding from THET’s Health Partnership Scheme. The partnership works collaboratively to support the development of stroke care in Ghana at the Korle Bu Teaching Hospital (KBTH), Accra.  Stroke is the second biggest cause of death in greater Accra, only preceded by Malaria (de-Graft Aikins, 2007).

In this blog, senior nurse, Colleen Lloyd, describes her experience volunteering with the partnership.

I felt very privileged to get involved with the partnership, and it was the start of an amazing journey with the Ghanaian nursing team. My first day on the wards at KBTH was a very humbling experience. I was used to working in UK hospitals with a great deal of resources, so I admired greatly the dedication of the Ghanaian nurses who worked with little resources, relying on their personal skills and whatever patient’s families could afford to care for patients.  Consequently, all aspects of my UK practice had to be re-thought and adapted to be meaningful in Ghana. And to match the compassion, dignity and a genuine passion for the role that the nurses had, which was very evident at all levels.

The UK nursing team, working alongside a multidisciplinary team, established nursing stroke skills on the medical wards at KBTH. The four clinical areas identified for development were swallowing, positioning, communication and continence.

The Ghanaian lead nurse was very welcoming and receptive to learning and improving her patient’s outcomes.  It was apparent from the outset that the goals would be small and very specific.

Dysphagia (swallowing problems) training was initially undertaken on a one-to-one basis using the train the trainer model.  The Ghanaian team had no experience of swallow assessments or the risk of aspiration despite pneumonia being very common in stroke patients in Ghana.  Having observed the patients being fed on my first day, I asked to meet the dietitian  Once I had explained the rationale behind our teaching, the response was amazing.  We looked at local foods which were cheaply available to families and adapted the various foods and fluids to suit the consistency required. The following day the lead stroke nurse proudly showed me her nursing team feeding patients the appropriate diets in the correct position.

All stroke patients admitted to the medical wards now have access to a stroke diet provided by the hospital kitchen. A major step in a very short time.

The importance of supporting families to understand the impact of stroke was also a key development aim. We produced a secondary prevention leaflet, which the lead nurse distributed during family meetings.
Funding has now been secured locally for the publication of this leaflet, which will be used to educate families of stroke patients and, hopefully, further influence families in the community. 

The lead nurse has a comprehensive learning log evidencing her learning as do all Ghanaian nurses who complete the training in the four stated clinical skills.  She also leads dedicated training sessions to all medical wards within KBTH and has visited other hospitals in Accra.

The stoke profile has been raised considerably at the hospital and a dedicated stroke unit at KBTH is due to open very soon.

I would strongly recommend working with an overseas health partnership. It is one of the most rewarding challenges a nurse can accept.

Colleen Lloyd (right) with Ghanaian consultant and team physio.

Visit the THET website to find out more about the Wessex-Stroke Partnership.